Abstract
Purpose: To identify survival predictors and to design a prognostic score useful for distinguishing risk groups in immunocompetent patients with primary CNS lymphomas (PCNSL). Patients and Methods: The prognostic role of patient-, lymphoma-, and treatment-related variables was analyzed in a multicenter series of 378 PCNSL patients treated at 23 cancer centers from five different countries. Results: Age more than 60 years, performance status (PS) more than 1, elevated lactate dehydrogenase (LDH) serum level, high CSF protein concentration, and involvement of deep regions of the brain (periventricular regions, basal ganglia, brainstem, and/or cerebellum) were significantly and independently associated with a worse survival. These five variables were used to design a prognostic score. Each variable was assigned a value of either 0, if favorable, or 1, if unfavorable. The values were then added together to arrive at a final score, which was tested in 105 assessable patients for which complete data of all five variables were available. The 2-year overall survival (OS) ± SD was 80% ± 8%, 48% ± 7%, and 15% ± 7% (P = .00001) for patients with zero to one, two to three, and four to five unfavorable features, respectively. The prognostic role of this score was confirmed by limiting analysis to assessable patients treated with high-dose methotrexate-based chemotherapy (2-year OS ± SD: 85% ± 8%, 57% ± 8%, and 24% ± 11%; P = .0004). Conclusion: Age, PS, LDH serum level, CSF protein concentration, and involvement of deep structures of the brain were independent predictors of survival. A prognostic score including these five parameters seems advisable in distinguishing different risk groups in PCNSL patients. The proposed score and its relevance in therapeutic decision deserve to be validated in further studies.
| Original language | English |
|---|---|
| Pages (from-to) | 266-272 |
| Number of pages | 7 |
| Journal | Journal of Clinical Oncology |
| Volume | 21 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Jan 15 2003 |
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ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Prognostic scoring system for primary CNS lymphomas : The International Extranodal Lymphoma Study Group experience. / Ferreri, Andrés J M; Blay, Jean Yves; Reni, Michele; Pasini, Felice; Spina, Michele; Ambrosetti, Achille; Calderoni, Antonello; Rossi, Andrea; Vavassori, Vittorio; Conconi, Annarita; Devizzi, Liliana; Berger, Françoise; Ponzoni, Maurilio; Borisch, Bettina; Tinguely, Marianne; Cerati, Michele; Milani, Mario; Orvieto, Enrico; Sanchez, Juvenal; Chevreau, Christine; Dell'Oro, Stefania; Zucca, Emanuele; Cavalli, Franco.
In: Journal of Clinical Oncology, Vol. 21, No. 2, 15.01.2003, p. 266-272.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prognostic scoring system for primary CNS lymphomas
T2 - The International Extranodal Lymphoma Study Group experience
AU - Ferreri, Andrés J M
AU - Blay, Jean Yves
AU - Reni, Michele
AU - Pasini, Felice
AU - Spina, Michele
AU - Ambrosetti, Achille
AU - Calderoni, Antonello
AU - Rossi, Andrea
AU - Vavassori, Vittorio
AU - Conconi, Annarita
AU - Devizzi, Liliana
AU - Berger, Françoise
AU - Ponzoni, Maurilio
AU - Borisch, Bettina
AU - Tinguely, Marianne
AU - Cerati, Michele
AU - Milani, Mario
AU - Orvieto, Enrico
AU - Sanchez, Juvenal
AU - Chevreau, Christine
AU - Dell'Oro, Stefania
AU - Zucca, Emanuele
AU - Cavalli, Franco
PY - 2003/1/15
Y1 - 2003/1/15
N2 - Purpose: To identify survival predictors and to design a prognostic score useful for distinguishing risk groups in immunocompetent patients with primary CNS lymphomas (PCNSL). Patients and Methods: The prognostic role of patient-, lymphoma-, and treatment-related variables was analyzed in a multicenter series of 378 PCNSL patients treated at 23 cancer centers from five different countries. Results: Age more than 60 years, performance status (PS) more than 1, elevated lactate dehydrogenase (LDH) serum level, high CSF protein concentration, and involvement of deep regions of the brain (periventricular regions, basal ganglia, brainstem, and/or cerebellum) were significantly and independently associated with a worse survival. These five variables were used to design a prognostic score. Each variable was assigned a value of either 0, if favorable, or 1, if unfavorable. The values were then added together to arrive at a final score, which was tested in 105 assessable patients for which complete data of all five variables were available. The 2-year overall survival (OS) ± SD was 80% ± 8%, 48% ± 7%, and 15% ± 7% (P = .00001) for patients with zero to one, two to three, and four to five unfavorable features, respectively. The prognostic role of this score was confirmed by limiting analysis to assessable patients treated with high-dose methotrexate-based chemotherapy (2-year OS ± SD: 85% ± 8%, 57% ± 8%, and 24% ± 11%; P = .0004). Conclusion: Age, PS, LDH serum level, CSF protein concentration, and involvement of deep structures of the brain were independent predictors of survival. A prognostic score including these five parameters seems advisable in distinguishing different risk groups in PCNSL patients. The proposed score and its relevance in therapeutic decision deserve to be validated in further studies.
AB - Purpose: To identify survival predictors and to design a prognostic score useful for distinguishing risk groups in immunocompetent patients with primary CNS lymphomas (PCNSL). Patients and Methods: The prognostic role of patient-, lymphoma-, and treatment-related variables was analyzed in a multicenter series of 378 PCNSL patients treated at 23 cancer centers from five different countries. Results: Age more than 60 years, performance status (PS) more than 1, elevated lactate dehydrogenase (LDH) serum level, high CSF protein concentration, and involvement of deep regions of the brain (periventricular regions, basal ganglia, brainstem, and/or cerebellum) were significantly and independently associated with a worse survival. These five variables were used to design a prognostic score. Each variable was assigned a value of either 0, if favorable, or 1, if unfavorable. The values were then added together to arrive at a final score, which was tested in 105 assessable patients for which complete data of all five variables were available. The 2-year overall survival (OS) ± SD was 80% ± 8%, 48% ± 7%, and 15% ± 7% (P = .00001) for patients with zero to one, two to three, and four to five unfavorable features, respectively. The prognostic role of this score was confirmed by limiting analysis to assessable patients treated with high-dose methotrexate-based chemotherapy (2-year OS ± SD: 85% ± 8%, 57% ± 8%, and 24% ± 11%; P = .0004). Conclusion: Age, PS, LDH serum level, CSF protein concentration, and involvement of deep structures of the brain were independent predictors of survival. A prognostic score including these five parameters seems advisable in distinguishing different risk groups in PCNSL patients. The proposed score and its relevance in therapeutic decision deserve to be validated in further studies.
UR - http://www.scopus.com/inward/record.url?scp=0037440231&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037440231&partnerID=8YFLogxK
U2 - 10.1200/JCO.2003.09.139
DO - 10.1200/JCO.2003.09.139
M3 - Article
C2 - 12525518
AN - SCOPUS:0037440231
VL - 21
SP - 266
EP - 272
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 2
ER -